[Triple therapy. Bad luck... or don't we still know how to treat?]

Area of Science:

• Cardiology
• Interventional Cardiology
• Thrombosis Research

Background:

• Acute myocardial infarction (AMI) necessitates timely intervention.
• Percutaneous coronary intervention with stent implantation is a standard treatment for AMI.
• In-stent thrombosis (IST) is a serious complication following stent placement.

Observation:

• A 65-year-old male presented with AMI and underwent successful primary angioplasty and stent implantation.
• The patient developed recurrent IST twice despite receiving triple antiplatelet and anticoagulant therapy.
• This recurrence occurred in the setting of optimal medical management.

Findings:

• Recurrent IST can occur even with aggressive antiplatelet and anticoagulant regimens.
• Optimal medical therapy may not always prevent stent-related thrombotic events.
• The case underscores the complexity of managing patients at high risk for IST.

Implications:

• Further research is needed to identify novel therapeutic strategies for preventing IST.
• Individualized treatment approaches may be necessary for patients with high thrombotic risk.
• This case contributes to understanding the limitations of current IST prevention protocols.